Creatine Monohydrate
The most evidence-backed performance supplement in existence.
Evidence tier
Strong
Research weight
Citations
19 verified / 19
Classification
Performance
❝
What the evidence says. Graded strong for strength, power and lean-mass gains alongside resistance training — hundreds of RCTs and a decades-long safety record. The cognitive benefits are weaker and contested (EFSA rejected the cognition claim and several RCTs were null), so that use is closer to preliminary. (Strong evidence: Multiple high-quality RCTs / meta-analyses with consistent effects.)
What is Creatine Monohydrate?
Creatine Monohydrate is a performance supplement used for strength & power. NutriDex grades the human evidence as Strong. Creatine increases phosphocreatine stores in muscle and brain, enabling faster ATP regeneration during short, intense effort. Hundreds of RCTs confirm reliable gains in maximal strength, power output, and lean mass when paired with resistance training. Emerging research points to cognitive benefits, especially under sleep deprivation or in vegetarians, and possible neuroprotective roles. It is among the safest and cheapest supplements with a decades-long safety record.
Purported Benefits
✓Strength & power
✓Muscle mass
✓Cognitive support
✓Recovery
Evidence by outcome
The same supplement can be well-proven for one use and unproven for another — here is the human evidence graded outcome by outcome.
| Outcome | Evidence | Effect | Studies |
|---|---|---|---|
| Strength & powerDozens of meta-analyses confirm reliable strength/power gains with resistance training; effect smaller in females and older upper-body. | Strong | ↑ benefit · moderate | 6 |
| Lean / muscle massMeta-analyses show ~1-2 kg added lean mass with training; effect requires concurrent resistance exercise. | Strong | ↑ benefit · moderate | 4 |
| Cognition / memorySmall memory gains in older/vegetarian or sleep-deprived states, but RCTs and EFSA/EFSA reject a general cognitive claim. | Mixed | ↔ mixed · small | 5 |
| Depressive symptoms (adjunct)One meta-analysis found a small effect (SMD -0.34) below the minimal important difference on very-low-certainty evidence. | Preliminary | ↑ benefit · small | 1 |
| Safety / tolerabilityAnalysis of 685 trials (~26,000 participants) found no increase in 35 evaluated side effects vs placebo. | Strong | ↑ benefit | 1 |
| Bone mineral densityMeta-analysis of 20 trials in older adults found no meaningful total-body BMD benefit (MD 0.009, p=0.557). | Moderate | — no effect · negligible | 1 |
Dosing & Compounds
Typical Dose
3–5 g/day. Optional loading: 20 g/day (split) for 5–7 days.
Active Compounds
Safety & Cautions
Very safe. Mild water retention early on. Does not harm healthy kidneys; consult a doctor if you have kidney disease. Educational only — always check with your doctor or pharmacist before combining Creatine Monohydrate with any medicine.
Key Studies ★ 19 studies
Meta-analysis
Desai 2024 meta-analysis
✓ PubMed
In 23 studies (~509 participants), creatine plus resistance training significantly increased upper-body (WMD 4.43 kg) and lower-body strength (WMD 11.35 kg) in adults under 50, with significant gains in males but not females.
Meta-analysis
Liu 2025 meta-analysis
✓ Full text
Across 8 RCTs (n=482 older adults), creatine plus resistance training significantly improved lower-limb strength and lean tissue mass versus placebo, with no significant gain in upper-extremity strength.
Meta-analysis
Xu 2024 meta-analysis (Front Nutr)
✓ PubMed
In 16 RCTs (492 adults), creatine monohydrate produced small significant improvements in memory (SMD 0.31), attention and processing speed, but no significant effect on overall or executive function.
Systematic review
Sharma 2025 meta-analysis (Br J Nutr)
✓ PubMed
Pooling 11 trials (1,093 participants), creatine showed a small effect on depressive symptoms (SMD -0.34; ~2.2 Hamilton points) that fell below the minimal important difference, on very-low-certainty evidence.
meta-analysis
Burke 2024 meta-analysis (J Strength Cond Res)
✓ PubMed
In adults under 50, creatine added to resistance training increased lean body mass by 1.14 kg (95% CI 0.69-1.59) and reduced body fat mass by 0.73 kg and body fat percentage by 0.88% versus resistance training alone.
meta-analysis
Forbes 2025 meta-analysis (Eur Rev Aging Phys Act)
✓ PubMed
Across 20 trials (1,093 older adults, ~69% female), creatine plus exercise training did not significantly improve total-body bone mineral density (mean difference 0.009, p=0.557) but did reduce fat percentage, indicating no meaningful bone benefit.
Meta-analysis
Nunes 2025
✓ PubMed
Pooled analysis of 69 studies (1,937 participants); creatine plus resistance training significantly increased bench/chest press strength (WMD 1.43 kg, 95% CI 0.53-2.34, p=0.002), squat strength (WMD 5.64 kg, p=0.001), vertical jump (WMD 1.48 cm, p=0.01) and Wingate peak power (WMD 47.81 W, p=0.004) vs placebo.
Meta-analysis
PeerJ 2025
✓ Full text
Meta-analysis of RCTs reported a significant overall improvement in muscle strength favoring creatine over control (SMD 0.43, 95% CI 0.25-0.61, p<0.01).
Meta-analysis
Candow et al. 2023
✓ PubMed
In adults <50 years (12 studies, 266 participants), creatine plus resistance training produced a small but significant reduction in body fat percentage (-1.19%, p=0.006), with no significant change in absolute fat mass (-0.18 kg, p=0.76). DOI: 10.3390/nu15204343
Meta-analysis
Prokopidis et al. 2023
✓ PubMed
Across RCTs in healthy humans, creatine improved memory versus placebo (SMD=0.29, 95% CI 0.04-0.53), with a markedly larger effect in older adults aged 66-76 years (SMD=0.88, 95% CI 0.22-1.55) than in younger adults (SMD=0.03, NS). DOI: 10.1093/nutrit/nuac064
Systematic review
Ma et al. 2025
✓ PubMed
Network meta-analysis of 19 RCTs in healthy older adults: combined with resistance training, creatine yielded the most pronounced improvement in muscle mass of any supplement tested (MD=2.18 kg, 95% CI 0.92-3.44; SUCRA 99.9%, outperforming protein and HMB), though its effect on muscle strength was non-significant (SMD=0.03, 95% CI -0.35-0.42). DOI: 10.3389/fnut.2025.1640858
Meta-analysis
Forbes et al. 2021
✓ PubMed
In older adults, creatine combined with resistance training significantly augments gains in lean tissue mass and strength versus placebo, independent of dosing strategy; loading followed by low-dose (<=5 g/day) and higher-dose (>5 g/day) protocols each improved chest-press and leg-press strength. DOI: 10.3390/nu13061912
Meta-analysis
Avgerinos 2018 meta-analysis
✓ PubMed
Improved short-term memory and reasoning, strongest in vegetarians/older adults.
Agency / regulator
EFSA NDA Panel 2024 (health claim opinion)
✓ PubMed
EFSA concluded a cause-and-effect relationship between creatine supplementation and improved cognitive function could not be established from the submitted evidence, rejecting the proposed Article 13(5) health claim.
Meta-analysis
Branch 2003 meta-analysis
✓ PubMed
Small overall effect size (ES ~0.2–0.4, largest for upper-body strength); no benefit for running/swimming.
Position stand
Kreider 2017 (ISSN position)
✓ PubMed
Most effective ergogenic aid for high-intensity exercise; safe long-term.
RCT
Sandkühler 2023 RCT
✓ PubMed
Double-blind crossover RCT in 123 healthy adults found 5 g/day creatine for 6 weeks gave only weak-to-moderate, non-significant cognitive benefit (e.g., backward digit span p=0.064; Raven's matrices p=0.327).
RCT
Gordji-Nejad 2024 RCT (Sci Rep)
✓ Full text
Double-blind crossover RCT in 15 healthy adults found a single high oral dose of creatine (0.35 g/kg) during 21 h of sleep deprivation raised brain phosphocreatine, reduced subjective fatigue, and improved cognitive performance and processing speed versus placebo.
Safety / toxicology
Antonio 2025 safety review (JISSN)
✓ Full text
Analysis of 685 clinical trials (~12,839 creatine vs 13,452 placebo participants) and global adverse-event databases found creatine did not increase the frequency of 35 evaluated side effects versus placebo and was well tolerated.